Association between Hypertension and Periodontitis: Possible Mechanisms

This review is to examine the current literatures on the relationship between periodontitis and hypertension as well as to explore the possible biological pathways underlying the linkage between these health conditions. Hypertension is one of the major risk factors for cardiovascular diseases. Oxidative stress and endothelial dysfunction are among the critical components in the development of hypertension. Inflammation has received much attention recently and may contribute to a pivotal role in hypertension. Periodontitis, a chronic low-grade inflammation of gingival tissue, has been linked to endothelial dysfunction, with blood pressure elevation and increased mortality risk in hypertensive patients. Inflammatory biomarkers are increased in hypertensive patients with periodontitis. Over the years, various researches have been performed to evaluate the involvement of periodontitis in the initiation and progression of hypertension. Many cross-sectional studies documented an association between hypertension and periodontitis. However, more well-designed prospective population trials need to be carried out to ascertain the role of periodontitis in hypertension

The significance of phytochemicals on periodontal health

Periodontal disease is an inflammatory disorder of tooth-supporting tissues that affects almost 90% of the population worldwide. The treatment of periodontaldisease involved mechanical therapy, surgery, and administration of antibiotics. The high cost of the treatment and bacterial resistance to certain antibiotics regime has led to the search for the alternative treatment to overcome the disease at less cost and side effects. Natural products had been proven to be an important source in developing modern medicine to promote general health. Herbal plant extracts had been widely used in oral health particularly to prevent bacterial plaque adherence and dental caries. In periodontal disease, several studies and reviews have documented that herbal plant extracts had the potential to prevent and treat periodontitis through their active ingredients associated with antimicrobials, anti-inflammatory, and anti-oxidant properties. The sources to obtain the herbs are readily available and economical to produce in the market. Some of the herbs had been marketed for public uses in the form of toothpaste and mouth rinses. This review is an attempt to outline the importance of herbal medicine to provide potential effective and economical medicaments for periodontal disease and its significance for further clinical research in the future

Kesan perencatan madu gelam terhadap kehilangan tulang pada tikus periodontitis

Periodontitis adalah penyakit kronik yang melibatkan kehilangan tulang dan inflamasi pada tisu periodontium. Interleukin-6 (IL-6) dan Tumor Necrosis Factor-α (TNF-α) merupakan penanda pro-inflamasi yang penting yang terlibat dalam periodontitis. Sebanyak 20 ekor tikus Sprague-Dawley dibahagikan kepada empat kumpulan iaitu: Kumpulan kawalan dengan salin normal (CS); kumpulan kawalan dengan madu Gelam 3 g/mL (CH); kumpulan ujian periodontitis dengan salin normal (TS); dan kumpulan ujian periodontitis dengan madu Gelam 3 g/mL (TH). Benang bersaiz 4/0 diikat pada molar pertama gigi tikus sebelah kiri bagi tujuan rangsangan penyakit periodontitis. Madu Gelam diberi secara paksa oral selama 15 hari. Selepas 15 hari, sampel plasma dan tisu dianalisis menggunakan kaedah Elisa dan pewarnaan histologi. Kehilangan tulang alveolar pada kumpulan TS adalah paling tinggi berbanding dengan kumpulan kawalan, CS dan CH namun, tiada perbezaan yang signifikan berbanding dengan kumpulan TH. Berdasarkan ujian imunohistokimia, ekspresi IL-6 dan TNF-α pada tisu periodontium adalah tinggi secara signifikan pada kumpulan TS berbanding dengan kumpulan lain. Namun, tiada perubahan aras IL-6 dan TNF-α yang signifikan pada plasma ke semua tikus kajian

Impact of rheumatoid arthritis functional status on oral and periodontal health in a multi-ethnic population

Periodontal disease (PD) has both been associated with the pathogenesis of Rheumatoid Arthritis (RA) and is also a comorbidity of RA. The aim of this study was to investigate the impact of the functional status of RA on oral and periodontal health in a multi-ethnic population. This is a hospital-based, multi-ethnic, observational study. Duration of illness, Disease Activity Score (DAS28), seropositivity and other rheumatological parameters were obtained from the records of RA patients attending the Rheumatology Clinic. Oral health examination was conducted on the subjects. Their functional status was assessed using the Health Assessment Questionnaire (HAQ) which includes categories in ‘dressing’, ‘rising’, ‘eating’, ‘walking’, ‘hygiene’, ‘reach’, ‘grip’ and ‘usual activities’. Data were analysed using ANOVA or Kruskal-Wallis test and Pearson’s Correlation or Spearman’s Rank Correlation Test. The 63 RA patients recruited had a mean disease duration of 10.7 ± 9.85 years with a mean of 19.9 teeth (± 7.18). The severity of PD worsens the longer the patients were suffering from RA (p=0.028). A high frequency (70%) of PD with 27% moderate and 27% severe, was observed. A significant association (p=0.035) was found between the ‘eating’ category of the HAQ and the average periodontal pocket depth. This study shows that there is a higher prevalence and severity of PD among RA patients in the selected population. The impact of functional status on periodontal health is mostly in the ‘eating’ category of the HAQ where patients reporting a disability in eating had higher average periodontal pocket depth

Isolation of lactobacillus from periodontally healthy subjects and its antimicrobial activity against periodontal pathogens

Bacteriocin or Bacteriocin like inhibitory substances (BLIS) is a protein antibiotic that has a relatively narrow spectrum of killing activity. It could potentially serve as a natural alternative to antibiotics in reducing the development of multi-drug resistant bacteria. Antimicrobial activity of the strains of Lactobacillus sp. isolated from healthy subjects (test strains) against Aggregatibacter actinomycetemcomitans and other periodontal pathogens (indicator strains) isolated from subgingival plaques of aggressive periodontitis patients were determined by using deferred antagonism test and agar-well diffusion method. Strains of Lactobacillus sp., Aggregatibacter actinomycetemcomitans and black pigmented bacteria were selectively isolated from TJA, TSBV and TSBA agars, respectively. Mean diameter zone of inhibition of at least 10 mm was considered as positive results for both methods. Out of 25 strains of Lactobacillus sp. screened, only eight test strains of Lactobacillus sp. showed the specific antimicrobial activity against certain strains of indicator periodontal pathogens during deferred antagonism test. However, out of eight potential strains, only three strains, which were Lactobacillus sp. strain S, Lactobacillus sp. strain V and Lactobacillus sp. strain W consistently showed positive inhibitory activity against black pigmented bacteria by deferred antagonism test and agar-well diffusion method. Therefore, these three strains should be considered as potential BLIS producer strains for further stud

Graduates’ and employers’ perceptions on competencies obtained from an undergraduate dental curriculum

The effectiveness of a dental curriculum as reflected by the competencies of the graduates is paramount in ensuring its relevance in the rapidly evolving field of dentistry. This work aimed to assess the competencies of dental graduates of the Faculty of Dentistry, Universiti Kebangsaan Malaysia (UKM) as perceived by the graduates and their employers on the basis of the core competencies listed in the undergraduate dental curriculum. A self-administered questionnaire consisting of 43 questions based on eight competency domains were sent to all UKM dental graduates of years 2012 to 2015 and to senior dental officers who represented their employers. The eight domains assessed were as follows: 1) gathering information at chair-side, 2) diagnosis, 3) treatment planning, 4) treatment and prevention, 5) community-based, 6) management and administrative, 7) communication and 8) personal management and professional development. a total of 132 graduates (75%) and 18 employers (55%) responded. Only domain E on community-based skills was collectively rated ‘satisfactory’ while the rest of the seven domains had an ‘excellent’ rating by all respondents. With regard to individual skill, basic life support was rated very low for both groups (38.6% graduates and 23.5% employers). A strong association was found between the scores given by the graduates and their employers (p= 0.00). Generally, no difference was found between the scores of graduates from different years. The findings allow an evaluation of the curriculum in a myriad of angles. Although the graduates reported a good level of competency in most domains, the employers were reserved on the community-based skills. Poor competency in the key skill of basic life support in medical emergencies was highlighted and must be addressed in the curriculum or during training at the workplace

Clinical and microbiological evaluation of stabilised periodontal patients undergoing early stage of orthodontic treatment

Orthodontic treatment may affect the equilibrium of oral microbiota which plays a major role in aetiology of periodontal disease. This prospective clinical study aimed to assess the periodontal health and microbiological profile of healthy (Group 1) and stabilised periodontal (Group 2) patients throughout three months of orthodontic treatment. Upper and lower fixed orthodontic appliances were bonded. Periodontal health was assessed using plaque score (PS), bleeding on probing (BOP) and pocket depth (PD). 29 sites were taken for subgingival plaque sampling. Plaque samples were inoculated on Trypticase Soy Blood Agar (TSBA) and Trypticase Soy Bacitracin Vancomycin (TSBV) agar for assessment of aerobe, anaerobe, black pigmented bacteria (BPB) and Aggregatibacter actinomycetemcomitans. All the measurements were taken before bonding (T0), 1 week (T1), 1 month (T2) and 3 months post-bonding (T3). Generally, periodontal health in both groups were almost similar. After 1 week, the number of aerobes was significantly higher in Group 1 (88%) while the anaerobes were significantly higher in Group 2 (45%). A. actinomycetemcomitans was higher in Group 1 at T0 and T1 but was significantly higher in Group 2 at T3. BPB was minimal at all time with no significant difference. Thus, during the first 3-month of orthodontic treatment, there were significant changes in the number of aerobes-anaerobes in both healthy and stabilised periodontal patients. Pathogenic bacteria would increase during early treatment of orthodontics